What are the short-term outcomes and complication rates after colorectal resection in a high-volume hospital operating under a CRM framework?
Colorectal resection performed within a mandatory institutional CRM framework is associated with a low complication rate (9.1%) and high in-hospital survival (98.6%).
Background: Postoperative complications after colorectal cancer surgery imply challenges to patient safety, recovery, and healthcare resources. Clinical Risk Management (CRM) is vital for reducing complications. This study aims to provide a comprehensive overview of short-term outcomes in a high-volume hospital over four years, evaluating the impact of complications through the lens of CRM. Methods: A retrospective cohort study was conducted on 483 patients (332 colon tumors, 151 rectal tumors) who underwent surgical resection. Data were extracted from the internal database, including demographic characteristics, diagnoses, surgical approaches, types of anastomoses, histological grades, and postoperative outcomes. Complications were categorized using the Clavien–Dindo system (grades I–V). Statistical analyses examined the link between clinical variables and complications. Results: Postoperative complications occurred in 44 (9.1%) patients in 483 cases. Among the 44 patients with postoperative complications, the most frequent events were anastomotic leakage (AL) (9/44, 20.5%; 9/483, 1.9% of the total cohort) and postoperative hemorrhage (POH) (8/44, 18.2%; 8/483, 1.7% of the total cohort). Moreover, complications were accompanied by an extended hospital stay and a higher in-hospital mortality (15.9% vs. 0%). The number of recorded postoperative follow-up visits differed significantly across complication severity categories. The overall in-hospital survival rate was 98.6%. Conclusions: The low rates of complications and in-hospital mortality observed in this cohort were documented within a hospital operating under a mandatory institutional CRM framework. However, due to the retrospective single-arm design, these findings should be interpreted as descriptive and hypothesis-generating rather than causal. The Clavien–Dindo system provided a useful tool for grading complication severity and supporting postoperative management. These findings support continued refinement of perioperative care pathways and further comparative studies on CRM implementation.
Ambrosi et al. (Wed,) studied this question.